For Australia, 2024 is predicted to be the hottest summer ever on record — and ours is a country already known for its warm weather.
What’s to come are daytime temperatures above 40 degrees, followed by evenings that leave us sweltering or relying on expensive air conditioning as we try to sleep through 25 and even 30-degree nights.
As a country known for its beaches, perhaps some regions are more prepared than others, but the fact is, weather like this triggers significant problems, especially for our healthcare system.
Globally, heatwaves lead to more ambulance call outs, emergency room visits, and tragically, deaths of some of our most vulnerable people also increase — people who can’t manage the skyrocketing costs of cooling their home, or those who don’t have the technology to do it.
With more summers like this on the way, now is the time for hospitals, aged care, disability care and other key providers of health and support services to plan, prepare and protect themselves against pending climate chaos.
Australia’s Infrastructure: Can It Shield Healthcare From The Heat?
For almost any country in this situation, some of the best defences, the best preventative measures, are smart public policy and well-designed infrastructure.
But with Australia in a state of flux, working hard to transition away from increasingly unreliable coal, gas and other non-sustainable resources, yet not set up adequately for the alternatives, can our struggling systems really keep up?
In 2022, as we sleepily started to emerge from our winter hibernation, Australia was met with dire warnings of a hot summer and predicted widespread electricity outages caused by too much pressure on power infrastructure.
Governments reassured us our devices would remain on and we didn’t need to worry, though they did also suggest conserving energy would be ‘useful’.
While major outages were avoided, minor outages left many wondering how we will manage in years to come.
In Adelaide, manual load shedding outages was scheduled to help support a power grid so strained by the use of air conditioning that it couldn’t keep up with demand.
Over the several years previous, it experienced similar conditions and similar outrages, as did parts of Sydney and Victoria in 2019, and Sydney and other regions again in 2020.
In 2018 and 2019, Queensland experienced such scorching temperatures that parts of a major highway — the road itself — started to melt, a phenomenon seen right across the state, and also quite commonly in New South Wales, South Australia and Western Australia.
Since 2015, similar stories reported train tracks buckling under the heat and public transport disruptions including people trapped in stuffy carriages stalled underground.
In addition to direct impacts on infrastructure, with such extreme temperatures, we see water restrictions become common and a reduction in air quality, impacting anyone who has existing respiratory illnesses.
The risk of fires also increases — many taking days or weeks to extinguish and causing widespread devastation and destruction to land and possessions, and injury and death to the people caught up in them.
Among all this chaos, are the first responders and the hospital emergency departments that are tasked with managing the human consequences.
Given these events indicate what can happen when temperatures rise above 40 degrees, and too few changes have been made to infrastructure and policy, the reality is that hospitals won’t be shielded, and will need to gear up for one of the most challenging summers ever on record.
Global Heatwaves: A Warning Sign
While many Australians might have chuckled at Brits who sunbaked at a balmy 18 degrees celcius, the fact is, heatwaves have become an increasingly common occurrence throughout the world.
As a result of this shared challenge, there are valuable lessons we can learn from the UK, Europe, USA and Middle East – before we face further increased temperatures here at home.
In 2018, England experienced significant heatwaves, with temperatures reaching almost 40 degrees in some locations; hot by all accounts, but scorching for that part of the world.
At the time, the NHS reported record numbers of people attending emergency departments at local hospitals, and authorities warned of increased risk of cardiac arrest, kidney and respiratory issues, and dehydration, among other conditions.
And as hospital visits climbed and people suffered, the knock on effect caused the delay of scheduled surgeries, meaning heatwaves had a prolonged impact that stretched far beyond the summer.
It also reported nurses who were not permitted to take water bottles into the ward were becoming patients themselves, suffering from dehydration and overheating.
In Italy in 2023, where heat waves saw record temperatures above 41 degrees in Rome and 45 degrees in Sardinia, hospitals experienced sharp escalations in people seeking emergency care, with some reporting a 20-25% increase in attendance.
The same report noted 231 patients attended emergency in a 24 hour period — the highest daily number since the system was strained to the brink of collapse due to the Covid-19 outbreak in 2020.
Further reports noted tourists fainting in Greece and Italy, and deaths of outdoor workers in the same countries.
Europe and the UK have not been the only locations impacted by rising global temperatures.
Iran has been hit with some of the warmest temperatures on record in 2023, with the mercury rising as high as 50 degrees celsius, and a two-day public holiday declared to reduce the risk of vastly increased public healthcare demand.
In the USA, data collated in Virginia across five summers (2016 – 2020) showed 80 heat events per summer, 400 additional ambulatory care visits for health-related illness, 4,600 additional emergency department visits, and almost 2,000 additional heat-related hospital admissions.
The report extrapolated the data nationally, predicting more than 230,000 emergency department visits and an added cost of $US1 billion for health care each summer.
Closer to home, a systematic review of the impact of extreme heat on healthcare in Australia revealed heat waves kill more people than any other natural hazard, with particular impact on vulnerable subgroups of the population. It noted that Tong et al. projected heat attributable costs in Perth alone, to increase to more than $125 million in the next decade.
The fact is, as we approach the years to come, and the much hotter weather they will bring with them, looking at the experiences of the world around us, and at our own past, can help us learn more about what we need to do to start adequately preparing.
New Technology: Preparing for the Heat
While governments wrestle with policy changes, infrastructure upgrades, warning systems and more, healthcare institutions like hospitals, can also implement internal changes that enable preparation and resilience.
Taking a leaf out of the books of our northern neighbours, working with governments, local businesses and communities to not only communicate better, but to share the load, can be a very positive starting point.
In Arizona, as a prime example, hospital facilities managers have recognised the influence of weather events, putting a variety of measures in place to support the community and their own teams.
In addition to improving their own infrastructure and technology, they have negotiated with administrators of the local power grid for the hospital to switch seamlessly and immediately to generator mode in periods of patchy electricity. This decreases the load on the power grid while reducing the impact of blackouts and brownouts on the hospital. In return, they are paid a premium, while having more reliable power.
To further enable their response, they have also reached an agreement with local business partners to ensure the hospital is first in line for key rental equipment like fridges, freezers and generators, during system failures and periods of peak demand.
For critical back-up systems, often high in cost, groups with several hospitals throughout the state, have collected important equipment between them so it can always be immediately available.
Outside of the hospitals’ own infrastructure, empowering residents with knowledge, helping them better understand the risks to their health, the signs of heat-related illness and how to prevent them, can reduce the number of people who suffer from the effects of high temperatures.
Likewise, communicating regularly with local organisations that support vulnerable populations — from the elderly to the homeless — can save lives… and reduce unnecessary increases in healthcare demand.
Making healthcare more available to the community without the need for a visit can also limit the traffic in busy hospitals. Covid-19 saw telehealth solutions and processes rise in prominence much faster than was ever anticipated, and we can continue to reap the rewards of that progress as we take on our next big challenge – climate change.
While community partnerships play a key role getting this information out to the right people, communication software can also enable automated, regular warnings and education, with minimal work from already overrun healthcare staff. It can essentially be a ‘set-and-forget’, that simply rolls out each year as the temperatures begin to rise.
Inside hospitals, integrating systems and departments that often feel the impact of either environmental factors or increased demand, bringing their data together, and engaging in real-time tracking can enable identification of potential bottlenecks or problems before they arise.
Automated incident management and alarm systems, real-time secure messaging and other solutions can open up communication and streamline responses for much faster operations.
Perhaps most important, collation and monitoring of data related to the hospital environment and all of its critical machines, can ensure temperatures remain optimal, ventilation is abundant and even refrigeration isn’t affected, both during the heat and in the aftermath of the severe storms that so often come with it.
Operational staff can know in an instant if anything changes, or anything shuts down, without even needing to leave their desks.
As the mercury rises, so does the challenge. But with proactive measures like better policies, improved infrastructure, the ability to closely monitor in real-time, and effective communication, Australia’s healthcare system can not only withstand climate change but thrive, despite its effects.
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